It’s embarrassing to admit, but I nearly quit graduate school. Multiple times.
That’s embarrassing to me because I made it through one of the most-failed pipelines in the U.S. military. My name is still on the wall of the schoolhouse at Naval Diving and Salvage Training Center. Yet counseling psychology had me, on more than one occasion, side-eyeing a proverbial bell to ring.
It wasn’t the academics. Those were easy. It wasn’t the workload, either. If anything, I’m the sort of person who can spend half a day writing an essay that only required half an hour if I’d wanted to do the bare minimum. No, what nearly drove me out of the profession was what I came to call worldview fatigue.
The transition from military special programs to psychotherapy was more than just a culture shock. It felt less like changing vocations and more like emigrating to an entirely different planet. I went from one of the most overwhelmingly male professional environments in America to one of the most overwhelmingly female.
The assumptions were different. The values were different. The language was different. Even the conception of what constitutes psychological well-being felt off. I had come from a world in which competence was king and formidability wasn’t a virtue so much as it was a prerequisite for everything else. In graduate school, however, it was emotional expression and vulnerability that were placed at the top of the pile.
Both emotional expression and vulnerability have their place. The problems begin when they become the only language a culture-shaping institution knows how to speak. By the time I learned that roughly three-quarters of American mental-health professionals are women, I wasn’t surprised. What surprised me was how few people seemed interested in discussing whether that fact might matter.
Modern academics are quick to point out that institutions are shaped by the people who inhabit them—that demographics influence culture, experiences shape priorities, and different groups bring different strengths and blind spots. Entire academic and corporate bureaucracies have been built around that premise in recent years. Yet when it comes to psychotherapy itself, many seem reluctant to ask whether a profession that is seventy-five percent female might develop blind spots of its own.
To be clear, I don’t believe every profession needs to mirror the demographics of the broader population. The fact that nursing is female-dominated doesn’t bother me. Neither does the fact that engineering remains overwhelmingly male. As long as the IVs get placed correctly and the bridges don’t collapse, I’m generally content to let people sort themselves into occupations according to their interests and aptitudes. The concern arises when an institution doesn’t merely perform a technical function, but also shapes the culture at large.
Given how psychologized Western culture has become in recent years, psychotherapy does more than just treat mental illness. It influences how we think about relationships, parenting, resilience, trauma, masculinity, femininity, emotional health, and even what constitutes normal human behavior. The language that comes out of the field finds its way into schools, corporations, government agencies, media organizations, and living rooms alike. Therapists don’t merely respond to culture. Increasingly, they help create it.
If there are meaningful psychological differences between men and women—and there are—it would be remarkable if those differences influenced every major institution except for the one tasked with defining psychological health itself.
The question isn’t whether women are capable of being great therapists. They are. The question is whether a profession that is overwhelmingly female might, over time, begin to mistake some female-typical preferences for universal psychological truths.
Men and women are not identical. On average, men tend to be more comfortable with competition, more inclined toward stoicism, and less likely to process distress through emotional disclosure. Women, on average, tend to score higher in empathy, agreeableness, and interest in people. Neither set of tendencies is inherently superior. Both have strengths. Both have weaknesses.
But if a profession becomes heavily populated by one group, it should not surprise us when that group’s preferences gradually become the profession’s assumptions. That possibility deserves particular attention when discussing men’s mental health. Every June, we are reminded that men are less likely to seek treatment, more likely to die by suicide, and more likely to struggle in silence. We are told that men need therapy. What we hear far less often is that therapy may need more men.
This isn’t an argument against women in psychotherapy. I know many exceptional clinicians, professors, supervisors, and colleagues who are women. It is simply another acknowledgment that professions are shaped by the people who inhabit them—and that psychotherapy should not be assumed exempt from that reality.
Recently, I was speaking with Dr. John Barry of the U.K. Centre for Male Psychology. We discussed many things, including the growing need for a U.S. equivalent. At one point, the conversation turned to the fact that I might never have entered the profession at all had the VA not paid for my education after I was medically separated from the military. He found it both interesting and familiar that graduate school had been difficult for me in ways that I never expected. Had I been on the hook for tuition, rather than actually getting paid to go to school, I suspect I would have quit.
John paused for a moment and then offered a thought that has stayed with me ever since.
If there were more guys like me—veterans and first responders, tradesmen and former athletes, men who had spent years in environments where competence, accountability, formidability, and resilience weren’t merely virtues but necessities—interested in human nature and fortunate enough to pursue the education required with funding, perhaps there were more coming than either of us realized.
Perhaps, for those who have spent years trying to bring balance back to the field, there was something like a cavalry on the horizon. I’ve never ridden a horse, and I haven’t the slightest idea how to blow a bugle. But I do know how to string together a few coherent words on occasion. Consider this my attempt at the call.
Perhaps psychotherapy doesn’t need fewer women. But it certainly needs more masculine men.
Female psychiatrist here. I totally agree with you and I would go even further. Our entire culture has become overly feminized and the result has been disastrous. We are living in a gynocracy and if we don't snap out of it, I fear for the future of Western civilization. I wrote about this here: https://pairodocs.substack.com/p/where-have-all-the-real-men-gone
and here: https://pairodocs.substack.com/p/where-have-all-the-real-men-gone-c3b
I wondered if you might have been having a bit of fun with the ambiguous essay title, initially reading it, slightly alarmingly, as putting men as patients, rather than practitioners, back into mental health. I wonder if there's a saturation point at which men might begin to wonder if it's worth the bother. Hopefully not.